Table 2 Included articles
From: Economic globalization, nutrition and health: a review of quantitative evidence
Included Articles | Methods | Definition of trade liberalization | Outcome variable | Region | Years | Main findings | Type of evidence | |
|---|---|---|---|---|---|---|---|---|
1 | (de Soysa and de Soysa, 2017) | Multivariate regression using country-level panel data | KOF index of globalization. Analyse trade openness and FDI components separately | Prevalence of obesity in young people aged 2–19 from GBD study | 180 countries | 1990–2013 | Trade openness and economic globalization result in lower obesity rates among the younger groups of population | BABCA |
2 | (Oberländer, Disdier, and Etilé, (2016) | Multivariate regression using country-level panel data | KOF index of globalization. Economic and social components analysed separately | Prevalence of diabetes; BMI; markers of dietary quality (animal protein, free fat, sugar) | 70 countries | 1970–2011 | Economic globalization negatively impacts health outcomes; socio-cultural globalization increases supplies of animal protein and sugar | BAACA |
3 | (Costa-Font and Mas, (2016) | Multivariate regression using country-level panel data | KOF index of globaliztion; economic and social components analysed separately; CSGR index | Prevalence of obesity | 26 HIC | 1989–2004 | Globalization significantly increases obesity; economic component reduces obesity (effect non-significant when accounting for various controls and potential mechanisms); social component increases obesity | BAACA |
4 | Goryakin et al., (2015) | Multi-country multi-level panel data controlling for both individual and country-level covariates. | KOF index of globalization and sub-components (economic, political, social) | Overweight and obesity | 56 countries | 1991–2009 | Globalization increases overweight, but the social and political components are the most relevant | ABBAA |
5 | Miljkovic et al., (2015) | Multivariate regression using country-level panel data | FDI; trade openness; Global Socialization Index (GSI) | Prevalence of obesity | 76 countries | 1986–2008 | Trade openness increases obesity in the fixed effects specification, but not in the quantile regression. FDI and GSI increase obesity for least developed countries, where obesity rates are low | BABCB |
6 | Sudharsanan,et al., (2015) | Non-parametric correlation and multivariate first-difference regression estimates | FDI | prevalence of diabetes in 10-year age groups | both HIC and LMIC | 1990, 2000, 2008 | Once ageing in population is taken into account, there is no evidence of FDI or other macroeconomic variables such as GDP, having an influence on prevalence of diabetes | BABAC |
7 | Nandi et al., (2014) | Meta-regression using multi-country cross-sectional individual level data. | Mean tariff percentage averaged 1990–1999. FDI | BMI; odds of being underweight, overweight and obese at the individual level for women in LMIC | 40 LMIC | 2002–2003 | Tariff reduction is associated with lower odds of being underweight. FDI is associated with higher odds of being overweight among rural men only. Higher income is associated to higher odds of being overweight | CAAAC |
8 | Neuman et al. (2014) | Multi-level modelling using cross-sectional data | FDI, mean tariff levels | BMI; over and under-weight | 38 LMIC | 1991, 2010 | FDI is positively associated with BMI among poorest respondents in rural areas | BAAAB |
9 | Vogli, R. de et al., (2014) | Multivariate regression using country-level panel data. | KOF index of globalization (economic component) | BMI | 127 countries | 1980–2008 | Globalization is positively associated to an increased BMI. Inequality also shows a positive association in high-income countries | BABCA |
10 | Schram, Labonte, and Sanders (2013) | Trend analysis and Structural Equation Modelling using multi-country cross-sectional data | KOF index of economic globalization | CVD, overweight, obesity | 39 countries | 2008 for SEM | Economic globalization negatively impacts all health outcomes. | CAACC |
Context-relevant proxies of nutrition outcomes | ||||||||
11 | Jenkins and Scanlan (2001) | Multivariate regression analysis with country-level panel data. | Foreign investment, dependence on primary exports | Child undernutrition (weight-for-age), per capita energy and protein availability | 88 less developed countries | 1970–1990 | There is a negative association between dependence on non-service exports and energy supply but this is non-significant after controlling for other economic variables. Neither FDI nor export dependence have an impact on child underweight | BAACA |
12 | Dithmer and Abdulai (2017) | Multivariate regression using country-level panel data. | Trade openness | energy consumption; diet diversity; diet quality | 151 countries | 1980–2007 | Trade openness increases average dietary energy consumption, dietary diversity and indicators of dietary quality | BAACA |
13 | Baker et al. (2016) | Difference-in-difference/Natural experiment | Ratification and enforcement of FTA with US | per capita sales of soft drinks | Peru | 1999–2013 | The study finds a diversification of soft drinks. Sales of carbonated drinks stagnate, but bottled water, sports and energy drinks increase | AACCC |
14 | Schram A, Labonte R et al., (2015) | Difference-in-difference/Natural experiment | Adoption of trade agreement, FDI | Consumption of carbonated beverages | Vietnam and Philippines | 1995–2012 | The adoption of a trade agreement increases per-capita sales of beverages | AACCA |
15 | Ogundari, (2015) | Multivariate regression using country-level panel data. | Trade openness | Nutrient supply, calories, proteins, fat | 43 countries | 1975–2009 | Trade openness seems to contribute to nutrient supply convergence in Sub-Saharan Africa | BACCA |
16 | Zakaria (2014) | Multivariate regression analysis using country-level panel data | Trade openness | Per capita availability of energy, fat | 5 South Asian countries | 1972–2013 | Trade openness and tariff reductions are associated with increased energy availability per capita | BACCA |
17 | Bezuneh and Yiheyis, (2014) | Multivariate regression analysis using country-level panel data | Implementation of liberalization policies (defined through dummy variables) | Per capita dietary energy supply | 37 developing countries | 1980–2000 | The removal of trade barriers is associated to short-term falls in nutrient availability per capita, with positive longer-term effects and insignificant “net” impacts | BACCC |
18 | Stuckler et al. (2012) | Multivariate regression analysis. | FDI, trade agreement with US | Sales per capita of sugar-sweetened beverages (SSB) | 44 LMIC | 1997–2010? | Both FDI and trade agreements with US increase sales per capita of SSB. Economic growth in the absence of FDI does not increase sales of SSB | BACCC |
19 | Djokoto (2012) | Cointegration analysis, time series using country-level data | FDI into agricultural sector | Per capita dietary energy supply | Ghana | FDI into the agricultural sector is detrimental for food security in Ghana | BACCC | |
20 | Mihalache and O’Keefe (2011) | Cointegration analysis, time series using country-level data | FDI into primary sector, manufacturing and service sector | Per capita dietary energy supply | 56 LMIC | 1981–2001 | FDI into the primary sector is detrimental for food security. FDI into manufacturing improves food security, FDI into services has ambiguous effects | BACCA |
21 | Del Ninno and Dorosh (2003) | Natural experiment. The authors compare three episodes of intense floods, their impact on crops, availability and price of rice, and calorie intake of affected households compared to those not affected | Liberalization of private-sector rice imports from India, in the early 1990s | Daily energy intake per capita | Bangladesh | 1977, 1988, 1998 | In the absence of private sector imports, per capita consumption of the rural poor would have decreased by 44 to 109 Kcal/Day, (out of an average of 1636). Public interventions including price stabilization and transfers also play an important role | AACCA |
22 | Wimberley and Bello (1992) | Multivariate regression analysis using country-level panel data | Primary export dependence; Transnational Company (TNC) investment | Per capita energy, and protein availability, total and from vegetable sources | 59 third world countries | 1967–1985 | There is evidence of a negative association between FDI and nutrition-related outcomes in developing countries, as well as a much smaller negative association for dependence on non-service exports | BACCA |
23 | Wimberley (1991) | Multivariate regression analysis using country-level panel data | TNC investment | Per capita energy and protein availability | 60 Third World Countries | 1970–1985 | There is a strong negative association between FDI and per capita availability of energy and protein in developing countries | BACCA |
24 | Gacitúa & Bello (1991) | Multivariate regression analysis using country-level panel data | Non-service exports as a proportion of GDP | Per capita energy, protein availability total and from vegetable; Z-score standardized measure of calorie and protein consumption | 15 Latin-American Countries | 1967–1985 | This study finds a negative association between dependence on non-service exports and per capita supply of energy and proteins in Latin America | BACCC |
Key literature reviews | ||||||||
1 | Barlow et al., (2017) | Systematic review | Adoption of trade and investment agreements | Health outcomes, risk factors | – | Trade and investment agreements can increase risk factors for NCD (beverage consumption) while also affecting protective factors (public health policies). However, certain agreements can increase access to patented medicines, with positive impacts on health | ||
2 | Baker P, Kay A, Walls H. (2014) | Semi-structured review | Trade liberalization, trade and investment agreements, others | prevalence of NCDs and main risk factors | ASEAN+ 3, India | – | Trade liberalization can promote NCD through two main pathways: increasing access to unhealthy products and constraining governments’ space to promote health | |
3 | Friel et al., (2013) | Review of literature and pathway mapping | Trade liberalization, trade and investment agreements, others | NCDs, obesity | Not restricted | – | The authors identify several pathways through which trade liberalization can affect NCD | |
4 | McCorriston S et al. (2013) | Systematic Review | Various. Trade and related policies | Food Security | Developing Countries | – | The authors find mixed evidence and a strong context-dependence of associations and impacts | |